Pashby v. Cansler
2011 U.S. Dist. LEXIS 141497
E.D.N.C.2011Background
- Plaintiffs challenge NC's IHCA Policy 3E, effective June 1, 2011, affecting in-home PCS eligibility for adults 21+.
- Policy 3E ties PCS eligibility to three qualifying ADLs or two with extensive assistance, requiring physician attestation and DMA CCME approval.
- NC CMS approved the IHCA plan and Policy 3E, but Plaintiffs allege violations of Medicaid comparability, ADA, Rehabilitation Act, and due process.
- Plaintiffs seek a preliminary injunction enjoining implementation of Policy 3E and continuation of PCS for those previously eligible.
- Defendant argues standing, mootness, ripeness, and that CMS approval defeats plaintiffs’ claims; court addresses these threshold issues.
- Court grants both class certification and preliminary injunction, preserving PCS for certain plaintiffs pending resolution.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Standing and mootness of named plaintiffs | Plaintiffs had standing at suit start; some claims not moot due to ongoing termination risk | Some plaintiffs’ actions post-date mootness; changes render claims moot | Standing found; claims not moot |
| Class certification under Rule 23 | Rule 23(a) and 23(b)(2) satisfied; commonality and adequacy shown | Challenged whether representative plaintiffs suffice for class | Class certified under Rule 23(b)(2) |
| Likelihood of success on the merits (Medicaid comparability) | Policy 3E violates Medicaid comparability by different standards for IHCA vs ACH PCS | CMS approval forecloses comparability challenge | Likelihood of success shown on comparability violation |
| ADA and Rehabilitation Act claims | Policy 3E risks segregation and violates integration mandate | Policy complies with program goals, no undue discrimination shown | Likelihood of success on ADA/RA claims |
| Procedural due process notice before termination | Notice lacked detailed justification for termination | Notice adequate under policy | Likelihood of success on due process claim; injunction granted |
Key Cases Cited
- Lujan v. Defenders of Wildlife, 504 U.S. 555 (1992) (establishes standing elements and injury-in-fact requirements)
- Abbott Labs. v. Gardner, 387 U.S. 136 (1967) (ripeness doctrine principles; premature challenges discouraged)
- Goldberg v. Kelly, 397 U.S. 254 (1970) (due process requirements for termination of benefits)
- Olmstead v. L.C., 527 U.S. 581 (1999) (ADA integration mandate; community-based services)
- Rhodes v. E.I. du Pont de Nemours & Co., 636 F.3d 88 (4th Cir. 2011) (standing/appeal context; relevance to class certification posture)
- Warth v. Seldin, 422 U.S. 490 (1975) (standing and prudential concerns in federal courts)
- Todd v. Sorrell, 841 F.2d 87 (4th Cir. 1988) (balancing harms in public interest analysis (precedent cited))
- Mayer v. Wing, 922 F.Supp. 902 (S.D.N.Y.1996) (irreparable harm considerations in injunctive relief)
- Doe v. Kidd, 501 F.3d 348 (4th Cir. 2007) (standing and ongoing relief considerations in challenges to ongoing deprivation)